Medicare Compliance & Reimbursement

If nursing home residents aren't offered vaccine, facility may violate new immunization rules.

Nursing homes nationwide could be hit hard this flu season, but new regulations, not pathogens, may deliver the biggest blow. Late in August, the Centers for Medicare and Medicaid Services promised to push the development of a final rule for new immunization standards for skilled nursing facilities.

The agency published a proposed rule in the Aug. 15 Federal Register, offering an abbreviated 15-day comment period. The proposed rule requires all Medicare or Medicaid-certified nursing facilities, as a condition of participation, to offer all residents (or their personal representatives) the pneumococcal vaccine and, in flu season, the influenza vaccine. Providers must give all residents, directly or through a personal representative, the chance to accept or refuse the two vaccinations.
 
Then, they should document the person's response as well as subsequent care (e.g., names of immunization(s) administered, immunization refused/patient educational materials offered). If the provider determines that an immunization is contraindicated, it should be documented in the medical record.

CMS expects the requirement to be in place for this flu season, said the agency's Sheila Lambowitz at the Aug. 30 SNF/Long-Term Care Open Door Forum.